The nation's foremost authority on post-traumatic stress disorder testified in federal court Monday that up to 30 percent of combat veterans of Iraq and Afghanistan are likely to be diagnosed with the ailment and that the Veteran's Health Administration is not doing enough to help them.

Dr. Arthur Blank, a psychiatrist who has worked with troops and veterans with PTSD since 1965, said the disorder is treatable, but it requires a "human connection" with a therapist, and that's something the VA is ill-prepared to support.

"With hope and with help, recovery is possible," he said.

Dr. Blank testified at a hearing in connection with a lawsuit brought by veterans advocacy groups against the VA, claiming that the federal government's health care system for troops returning from Iraq and Afghanistan illegally denies care and benefits.

The plaintiffs, Veterans for Common Sense and Veterans United for Truth, are seeking to make the case a class action on behalf of 320,000 to 800,000 veterans or their survivors. The hearing Monday concerned a request by the veterans groups that the judge issue a preliminary injunction ordering the VA to provide immediate mental health treatment for veterans who suffer from stress disorders and are at risk of suicide.

In educational interest, article(s) quoted from extensively.

Continuing:

In opening statements, an attorney for the veterans groups, Gordon Erspamer, offered a litany of problems with the VA, from long waits at outreach centers to a scarcity of medical facilities in rural states, especially in the West.

District Judge Samuel Conti said he was a little unclear as to what he is legally able to order in this case. "We have a lot of strictures from Congress that give me very limited jurisdiction in this case," he told attorneys for both sides. "You might need to tell me exactly what you think I can do. It's like walking through a minefield." ...The suit claims the government's failure to provide timely treatment is contributing to an epidemic of suicides among returning soldiers.

Blank said suicide is often the result of post-traumatic stress that is untreated, or poorly treated. He said combat veterans are about twice as likely to commit suicide as the general population. "Timing is of the essence," Blank said. "It's important to respond early."

Attorneys for the government argued that Blank has not worked with the VA for more than 10 years and is ill-equipped to comment on what services the VA provides its patients.

Dr. Gerald Cross, principal deputy undersecretary for health at the Veterans Health Administration, agreed that veterans who are suicidal, or suffer from PTSD, need prompt help, but said that the VA centers around the country do a good job of identifying those veterans and getting them help.

Cross said there has been no comprehensive study done by the VA on suicides by combat veterans, but one is in the works and has been submitted to the New England Journal of Medicine for review. That study should be published soon, he said. CBS News conducted its own study of suicide rates among veterans nationally, and the study showed that in 2005 approximately 120 veterans committed suicide each week of that year. Cross said CBS declined to give the VA the data it collected for its story.

The hearing will continue at the federal courthouse in San Francisco throughout the week.

The lawsuit comes amid intense political and public scrutiny of the VA and Pentagon after reports of shoddy outpatient care of injured soldiers at Walter Reed Army Medical Center and elsewhere. Suicides and suicide attempts continue to rise, the Pentagon reports. ...

U.S. District Judge Samuel Conti is scheduled to hear from dueling mental health experts this week to determine whether he should order the VA to immediately spend about $60 million to provide care to hundreds of thousands of veterans they say have pending health claims.

"The VA has repeatedly failed to implement programs," veterans' lawyer Gordon Erspamer told the judge. "Mental health funding is not being spent on mental health."

Erspamer urged the judge to act soon to fix a health care system he says is plagued by staffing shortages, high turnover and a crushing need to treat about 56,000 patients with post-traumatic stress disorder. Erspamer argued the demand is expected to increase as more soldiers return from combat zones.

"What is going to happen to the health care system when they all return?" he asked the judge. The judge responded that he was concerned he had scant authority to tell the VA how to spend its budget, even if he does determine there are problems.

"I have very limited jurisdiction," Conti said.

U.S. Department of Justice lawyer Daniel Bensing echoed that by telling Conti that issuing such an order had the practical effect of putting the judge in charge of patient care. The veterans' demands are "unwarranted, unworkable and would do more harm than good."

The VA has made "massive changes," Bensing said, adding new resources and mental health workers since 2005 in response to veterans returning from Iraq and Afghanistan. "It is not the policy of the VA to turn away veterans when they need emergency care," he said. "They get emergency care."

While a wide variety of events can trigger what's called post-traumatic stress disorder, this PTSD blog focuses solely on the combat-related variety.
As a new generation of warriors returns to civilian life and seeks out resources, PTSD Combat is here to help.

Considerable Quotes

"The first shamans earned their keep in primitave societies by providing explanations and rituals that enabled man to deal with his environment and his personal anguish. Early man, no less than we, dealt with forces that he could not understand or control, and he attempted to come to grips with his vulnerablity by trying to bring order to his universe." -- Richard Gabriel in No More Heroes

"War stories end when the battle is over or when the soldier comes home. In real life, there are no moments amid smoldering hilltops for tranquil introspection. When the war is over, you pick up your gear, walk down the hill and back into the world." -- OIF vet John Crawford in The Last True Story I'll Ever Tell

"After wars' end, soldiers once again become civilians and return to their families to try to pick up where they left off. It is this process of readjustment that has more often than not been ignored by society. -- Major Robert H. Stretch, Ph.D in Textbook of Military Medicine: Vol. 6 Combat Stress

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